Male Health Education Dr. Ariella Friedman Division of Pediatric Urology Cohen Children’s Medical Center North Shore – Long Island Jewish Health System New Hyde Park, NY

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Outline 

Male Reproductive System



Puberty



Testicular Torsion



Testicular Cancer



Other Problems Affecting Male Genitals



Sexually Transmitted Infections



Q&A



This talk will not include extensive discussion of sexuality or contraception

What is the Male Reproductive System? 

Most species have two sexes: male and female



Each has its own reproductive system





Differ in shape and structure



Both designed to produce, nourish, and transport egg or sperm

Roles of the male reproductive system: 

Produce sex hormones (which contribute to development during puberty)



Produce and release sperm into the female reproductive system  Unite with an egg  fertilization

Reproduction 101  Two types of sex cells (gametes) 

Egg (female)



Sperm (male)

 Each gamete made of 23 chromosomes (haploid, or half

the 46 chromosomes typical of a person) 

22 autosomes



1 sex chromosome  Egg: X chromosome only  Sperm: X or Y chromosome



Each chromosome has dozens to thousands of genes

Sperm Production  Millions of sperm produced daily, beginning in puberty 

Each: 1/600th of an inch long

 Develop in tiny tubes within the testicles called

seminiferous tubules

 Cells divide and change until they reach their mature shape 

Head contains the chromosomes



Body provides energy (mitochondria)



Tail allow motility to swim push themselves into the epididymis, where they complete their development

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 reaf

Factors That Can Impair Sperm Production and Quality  Increased scrotal

 Toxins

temperature

 Smoking

 Tight underwear

 Alcohol

 Prolonged biking

 Marijuana, heroin,

 Hot tubs  ?Laptop on lap

 Chemotherapy, radiation  Steroids

cocaine  Certain medications

 Certain lubricants

Sperm Transport  Sperm is made in the testicles and transported through

the male reproductive tract

www.kidshealth.org

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Male Reproductive System  Testicles (Testes)  Oval-shaped, 5x3 cm  Two functions  Produce and store millions of sperm  Produce testosterone (responsible for the changes seen in

puberty and sperm production)  From here, sperm travel to the epididymis

Male Reproductive System Duct System  Epididymis 

Sits next to and above each testicle (like a helmet)



Tightly coiled tube in which sperm are stored



It takes sperm about 4-6 weeks to travel through the epididymis



From here, sperm enter the vas deferens

 Vas deferens (ductus deferens) 

Thin, muscular tube



Transports sperm from each epididymis to the urethra

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Epididymis

Male Reproductive System Accessory Glands  Seminal vesicle 

Secretes a thick liquid that nourishes the sperm

 Prostate 

Walnut-sized gland that surrounds part of the urethra



Contributes some fluids to semen

Semen =  Sperm (from testicles)  Seminal fluid (from seminal vesicles and prostate) www.kidshealth.org

Male Reproductive System  Urethra  Tube that carries semen and urine out the penis

 Penis  Two parts:  Shaft  Glans (head)

 Delivers semen through the urethra into the female

reproductive tract



Male Reproductive System Scrotum (Sac) 

Contains the testicles and epididymis



Hangs under the penis



Helps regulate testicles’ temperature  Sperm made at cooler temperatures than body temperature  Changes size depending on temperature  Cold  shrinks, tightens to trap heat  Warm  larger and floppy to shed extra heat

 Spermatic Cord 

Cord that drains blood vessels, vas deferens, and nerves to and from testicle

Erection  The penis is made of spongy tissue and generally

hangs limp  Erection: hardening of the penis when the

sponge-like tissue inside fills with blood  Rigidity facilitates insertion during intercourse

Ejaculation  Release of semen through the urethra (the opening at

the tip of the penis)  Muscles around the reproductive organs contract and

force semen through the duct system and urethra  Ejaculate can contain up to 500 million sperm

Fertilization  Ejaculation causes semen to be deposited into the

female vagina  Sperm travel through cervix, uterus, and to fallopian

tubes  If a mature egg is present in the fallopian tube and a

sperm penetrates it, fertilization occurs, and the fertilized egg becomes a zygote

How Does the Male Reproductive System Develop?  When a baby is born, all parts of the reproductive

system are in place  At puberty, the ability to reproduce begins

Puberty  Usually starts around 9-15 years of age in boys 

Girls: 8-13 years



Late starters almost always catch up fine – they just reach full maturity a little later

 Chemical (endocrine) basis for puberty 

Body produces increased hormones (androgens ie testosterone, and estrogens)



Boys have mostly androgens, and small amounts of estrogen in their systems



In male puberty, androgen production is increased the most, while estrogen production generally remains low

Endocrine Control of Puberty 

Hypothalamus releases GnRH



This stimulates the pituitary gland to make FSH and LH



LH: acts on Leydig cells of the testicle to produce testosterone



FSH: acts on Sertoli cells of the testicle to produce sperm



Testosterone: provides negative feedback to Hypothalamus and Pituitary to prevent overproduction

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Puberty  Associated with several physical and emotional changes  Sequence of physical changes

Scrotum and testes enlarge

Penis enlarges, seminal vesicles and prostate grow

Hair appears (pubicface underarms, chest), voice deepens

Growth spurt

Sexual Maturity (Tanner Stages) Tanner Stage

Testes Volume

Scrotum

Penis

Pubic Hair

1

20 ml

Adult

Adult

Adult type and quantity, extends to inner thigh

 However, all

boys develop differently  Different

ages  Different

rates of change

Changes In Genitals  Concern over timing of development compared to

brothers or friends  No exercises, supplements or diets speed development

or change penis size  Concerns over final appearance  How size relates to manliness or sexual function (it

doesn’t!)  How the penis may hang to one side or another (this is

normal)

Changes in Body Shape  Growth spurt 

Begins around 11 y.o. (varies), 9 y.o. in girls



Lasts around 2-3 years



Boys generally 12-13 cm (4.7-5.1 in) taller than females  Delay in bone closure relative to girls  Slightly more growth during growth spurt

 Shoulders broaden

Male height prediction:

 Muscles get bigger

(Father’s height + 13 cm) + mother’s height 2

 Weight gain 

May contribute to unhealthy behaviors to try to lose weight

Voice Changes  Occur around age 11-15, may be later

 Voice deepens due to several factors  Larynx (voicebox) grows and angles outwards (Adam’s

apple)

 Facial bones grow  Sinuses grow

 Voice deepens but not all at once  voice cracking  Voice cracking stops with growth (usually lasts a few

months), and voice will ultimately stay in the lower range

Development of Breast Tissue (Gynecomastia) 

Sometimes, boys produce enough estrogen in puberty to develop breast tissue 

One or both sides



Tender



Completely normal and common (occurs in ~½ of boys undergoing puberty



Almost always temporary





Flatten out within a few months to 2 years (no surgery or medication necessary)



Very unusual to stay developed

Can be embarrassing – boys may feel more comfortable in loose-fitting shirts in the meantime

Gynecomastia  Puberty is the most common cause of gynecomastia  Other causes of breast growth not relating to puberty  Medication side effects

 Illegal drugs  Anabolic steroids  Marijuana  Heroin

 Pseudogynecomastia (extra fat in the chest area but not

breast tissue)

Acne  Almost all teens get acne  Contributing factors:  Skin gets oilier

 Increased sweating  Endocrine

 Daily hygiene (face washing,

deodorant/antiperspirant) become important  Medications available for severe acne

Erections  Become more frequent during puberty  Can go away on their own or after ejaculation  Can be normal to get many or no erections during a

day  What causes erections?  Sexual arousal (TV, fantasies)  No particular reason (normal even without a context)

 Concerns over erections in public (reassurance)

Nocturnal Emissions (Wet Dreams)  Guys have several erections (about 3-5) and arousal periods

while in the REM stage of sleep (when most dreams occur)

 This can lead to ejaculation on occasion  If this happens during sleep, boys might wake up to find

that pajamas and sheets are wet

 Don’t cause harm but can be embarrassing and confusing  Some may find it helpful to sleep with a towel nearby or

bring spare underwear if sleeping at a friend’s house

 Frequency of unexpected erections and wet dreams

decreases after puberty

Problems Affecting the Male Reproductive System

Testicular Injury  Testicles are vulnerable to injury due

to their location outside the body (not protected by bones or muscles)

 Most injuries occur when the testicles

are struck, hit, kicked, or crushed  Sports or other trauma

 Most injuries do not cause

permanent damage

 Symptoms: pain, nausea

Testicular Injury  Minor injuries  Pain gradually subsides in < 1 hour  Symptomatic relief:  Pain medication  Rest  Supportive underwear

 Ice packs

 Avoid strenuous activity for a few days

Testicular Injury  Severe injury not treated in a timely manner can lead

to testicular loss  Seek medical attention IMMEDIATELY if:  Pain doesn’t subside or is extreme  Associated bruising/swelling (may have a testicular

fracture or rupture)  Continued nausea or vomiting  Fever  Puncture to scrotum

Preventing Testicular Injury  Athletic supporter (jock strap) –  Binds the testicles and keeps them

stationary, close to the body  Should be worn as soon as boys are

involved in activities that can lead to groin injury  Contact or non-contact sports  Strenuous exercise, cycling, or heavy

lifting

Preventing Testicular Injury  Protective plastic inserts (“cups”) further

help prevent blunt trauma injury  Especially important for high-impact

sports  Football, soccer, hockey, baseball,

basketball, karate  Made of hard plastic or steel, perforated

for ventilation  Inserted into athletic supporter or

compression shorts

Preventing Testicular Injury  Athletic supporters and cups should be used whenever

possible and available  Similar to wearing a helmet or shin guards  In younger boys, wear tight-fitting briefs

Testicular Torsion  Spermatic cord (cord

containing the vas deferens, nerves, and blood vessels to testicles) twists, causing the blood supply to be cut off  Blood (oxygen) can’t flow

to the testicle  testicle is at risk for permanent injury or death

 1/1500-4000 boys by age 25  Most common ages: 11-19

Testicular Torsion  Symptoms:  Sudden, severe scrotal pain  May increase or decrease but generally won’t go away

completely  Pain may travel to groin or abdomen

 Nausea, vomiting  Scrotal skin changes or swelling (late finding)

What Causes Testicular Torsion?  Most of the time, no obvious cause

 Can occur after:  Trauma

 Strenuous exercise  Changes in weather

 Testicular torsion is a medical emergency that

requires immediate attention to help prevent testicular loss

Testicular Torsion  Factors associated with increased likelihood of

damage or testicular loss  Degree of twisting  May be anywhere from 180-1080 degrees

 Duration of pain from symptom onset until definitive

treatment Treatment within:

Likelihood of saving the testicle

6 hours

90-100%

6-12 hours

50%

16 hours

25%

>18-24 hours

0-10%

Long-Term Risks of Testicular Torsion  Testicular loss  Concerns over body image and masculinity  Feelings of shame or uneasiness  Can be associated with depression or anxiety

 Feelings of parental/caregiver guilt

 Testicular salvage  Impaired testicular growth  Also relates to time from symptom onset until treatment

 Impaired fertility possible in both scenarios International Journal of Andrology, 2010

Testicular Torsion  Even though rates of testicular salvage are excellent

when treatment is prompt (90-100%), actual salvage rates are much lower at ~65%  Reason: delay in treatment  Children have higher rates of presentation delay and

testicular loss compared to adults  Only about a third of boys with testicular torsion present

within 6 hours of pain onset  The most important way to prevent loss of a testicle

from testicular torsion is prompt presentation after symptom onset

Testicular Torsion: Management  If a boy has sudden, severe testicular pain, he needs to

go to the emergency room immediately  Ultrasound – checks for blood flow to the testicle  Surgery – untwist and secure in position if healthy,

remove if too much damage  Boys need to be encouraged to notify an adult if they

are having severe scrotal pain  While it may be embarrassing for boys to talk about

their genitals, ignoring the pain can have drastic consequences

Testicular Torsion: Management  If the pain goes away on its own, its possible a torsion

occurred and then untwisted on its own (intermittent torsion)  Still need to see a healthcare provider  There is a risk of it happening again in the future to the

same or opposite testicle  Need to evaluate for other causes of scrotal pain

Testicular Torsion  Torsion much more common than testicular cancer –

should be taught in the male health curriculum

Wellness : All students will acquire promotion concepts and skills to support a healthy, active to suppo 2.12.1 Wellness : All students willhealth acquire health promotion concepts and skills lifestyle. lifestyle. Grade 8 The

prevention and Grade 8 The control of diseases prevention and

and health conditions

2.1.8.C.1 Evaluate emerging methods to diagnose and treat

control of diseases are affected by many factors. and health conditions

diseases and health conditions that are common in young adults in the United States and other countries, Evaluate emerging methods to diagnose and treat 2.1.8.C.1 including hepatitis, sexually transmitted infections, and conditions HIV/AIDS, diseases breast cancer, HPV,health and testicular cancer. that are common in

are affected by many factors.

2.1.8.C.2

young adults in the United States and other countries, including hepatitis, sexually infections, Analyze local, state, national, and international public transmitted health efforts to prevent and control diseases and health HIV/AIDS, breast cancer, HPV, and testicular cancer. conditions.

Grade 12 Personal health is impacted 2.1.8.C.2 by family, community, national, and international efforts to prevent and control diseases and health conditions.

Analyze local, state, national, and international public health efforts to prevent and control diseases and health conditions. 2.1.12.C.1 Predict diseases and health conditions that may occur during one’s lifespan and speculate on potential prevention and treatment strategies.

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Testicular Torsion

 If interested in a FREE copy of this video, which can be

shown in health class, please see me after the presentation or email me: [email protected]

Testicular Cancer  Rare cancer (5/100,000 boys per year)  Most common cancer in boys/men ages 13-35  Symptoms:  Hard mass in the testicle  Usually painless

 May be discovered after an injury (but it is not caused

by injury)  Almost always curable when caught and treated early

Testicular Self-Exam (TSE)  A way for guys to check their own testicles to make

sure there aren’t any unusual lumps or bumps  Can be the first sign of testicular cancer

 Important to perform MONTHLY to become familiar

with the size and shape of the testicles  Easier to tell if something feels abnormal or different in

the future

How to Perform a TSE  When? 

Best right after a hot shower or bath  Scrotum is most relaxed then, making

the exam easier to perform

 How? 

Examine one testicle at a time



Use both hands to gently roll each testicle (with slight pressure) between the fingers



Place thumbs over the top of the testicles, with the index and middle fingers of each hand behind the testicles, and roll it between the fingers

What Should Be Felt During a TSE?  Testicles 

Feel for any lumps or bumps along the front and sides  May be as small as a piece of rice/pea, although may be larger



Normal to have one testicle slightly larger than the other

 Epididymis 

Soft, rope-like, slightly tender to pressure, located at the top and back of each testicle



This is a normal lump

 Inform a doctor right away if: 

Any swelling, lumps, or changes in size or color



Any achy areas

Additional Problems Affecting the Male Reproductive System

Varicocele  Varicose (abnormally swollen) testicular

veins

 Commonly develop during puberty 

Growing testicles require larger blood supply



15% of guys between 15-25 year old

 Symptoms 

Usually none



Dilated veins in scrotum  “Bag of worms”



Dull ache, heaviness, discomfort, or dragging in the scrotum

Varicocele  May affect future fertility (but often does not)  Most varicoceles do not require treatment  Treatment (surgery) indicated if  Testicular growth is impaired (heat)  Pain

Epididymitis/Orchitis 

Inflammation and pain of epididymis or testicle



Causes:







Infection



Other/Unknown

Symptoms 

Scrotal pain – need to see a doctor to rule out other more harmful causes of scrotal pain



Occasionally fever or burning with urination

Treatment 

Symptomatic relief (Motrin, ice)



Avoid sports activity until pain resolved



Occasionally: antibiotics

Inguinal Hernia  Opening or weakness

in the wall of the groin muscles  If large enough,

intestine may protrude through the inguinal canal (passageway from abdomen to scrotum)

 If small, only

abdominal fluid drains into the scrotum

Inguinal Hernia  Cause: combination of muscle weakness (usually

congenital) and strain 

Obesity or sudden weight gain



Lifting heavy objects



Diarrhea or constipation



Persistent coughing or sneezing

 Symptoms 

Bulge or swelling in the groin



Pain, especially with activities that involve straining



Often detected on a physical exam at the doctor (“turn your head and cough”)

Inguinal Hernia  Danger of a hernia 

Bowel can get stuck (in very severe cases, causing injury to the bowel)

 Corrected with surgery  Preventing hernias 

Maintain a healthy weight



Fruits, veggies, whole grains (fiber  prevents constipation and straining)



Careful when lifting weights or heavy objects



Quit smoking

Jock Itch  Fungal infection (ringworm) affecting the groin, skin

folds, inner thighs, buttocks (usually not on penis or scrotum)  Cause: tinea cruris – grows in warm, moist areas  Damp towels, sweaty workout clothes, wet floors  Public showers and lockers increase risk

 Athlete’s foot (tinea pedis): a similar fungal infection of

the foot

Jock Itch  Symptoms:  Rash with patches that may be red or peeling  Scales or bumps on the edge that look like blisters

 Often itchy

Jock Itch  Treatment 

OTC antifungals and powders (Lamisil, Lotrimin, Micatin, Monistat)  Use as directed for full duration over entire rash and

beyond edges



Compresses for blisters



Medical attention if severe, recurrent, or does not resolve in 2 weeks

 Prevention 

Keep groin, inner thighs, and buttocks clean and dry



Wash workout clothes and towels after each use



Shower shoes in public showers (Athlete’s foot)

Foreskin  All boys are born with foreskin (fold of skin at the end

of the penis, covering the glans)  Normally, can be pulled back (retracted) from over the

head of the penis and then returned back to its resting position

Problems of the Foreskin 



Phimosis – inability to retract the foreskin from over the head of the penis 

May trap urine  ballooning of foreskin during urination



Physiologic: normal not to be able to pull foreskin back at younger ages (ie before puberty)



Pathologic: abnormal when associated with scar, inflammation, or pain

Paraphimosis – entrapment of retracted foreskin behind the head of the penis 



Painful, swollen glans

Balanitis – inflammation of the foreskin (redness)

Foreskin Hygiene  Retract foreskin daily (gently) to clean underneath with

soap and water 

Never force the foreskin back  tears, inflammation, scarring



Avoid excessive washing

 Always return foreskin back over the head of the penis 

After cleaning



After sexual activity

 Paraphimosis is a medical emergency  Phimosis and balanitis should be seen by a healthcare

provider but generally less urgently (depends on severity)

Circumcision  Usually performed in newborns by a doctor or

clergy

 Not medically necessary 

Family preference based on religion, culture, social, or hygiene concerns



Reduce risk of diseases (UTI, STI) and cancer in select circumstances



May be recommended for certain cases of phimosis, paraphimosis and balanitis

 Penis works the same, whether circumcised or

not

 No credible evidence that circumcision reduces

sensation

Sexually Transmitted Infections (STIs)

STIs  STI = Sexually transmitted infection

 STD = Sexually transmitted disease  Disease = infection that causes symptoms, but many

sexually transmitted infections do not have symptoms

 Consequences of STIs  Pain

 Infertility  Problems to other organ systems  Death

STIs  All boys who are sexually active or considering having

sex should get regular male genital exams  STI education  STI checks

STIs  How are STIs spread: 

Mucous membranes (Vaginal, oral, anal intercourse)



Skin-to-skin



Blood products

 Risk factors for STI transmission 

Initiation of sexual activity at a young age



Higher number of sexual partners



Unprotected sex  Not all forms of contraception prevent STI transmission

(oral contraceptive pills, spermicides, diaphragms, intrauterine devices)

STI Myths  Myth: only “trashy” people get STIs  Fact: STIs don’t discriminate

 Myth: Condoms are 100% effective in preventing

STIs

 Fact: Only abstention from any form of sexual activity

is 100% effective

 Myth: If your partner has an STI, you’ll see it  Fact: There’s often no sign that a person has an STI  People might not know they have STIs

 Even healthcare professionals utilize lab tests for

diagnosis

STI Myths  Myth: You can avoid STIs by having oral or anal sex  Fact: Any sexual contact can lead to STI transmission  Skin-to-skin (herpes, genital warts)  Mucous membranes

 Myth: Once you’ve had an STI, you’re immune from

reinfection  Fact: You can get some STIs more than once  Getting treatment for a partner can help prevent

reinfection for certain diseases

Herpes  Virus: Herpes Simplex Virus (HSV)

 Two strains may cause genital herpes 

HSV-1 – typically cause more mild blisters (ie cold sores)



HSV-2 – more virulent strain, more often associated with genital herpes

 Transmission: 

Skin-to-skin contact



Oral, anal, vaginal sex (mucous membranes)



NOT toilet seats

Herpes - Symptoms  Begin 2-20 days after exposure  Itching, pain, tenderness in genital area  Sores (vagina, penis, scrotum, buttocks, anus) 

Red bumps  red, watery blisters  ooze or bleed

 Pain with urination

 Flu-like symptoms (fever, headache, swollen lymph nodes)  Initial outbreak is most severe; subsequent outbreaks more

mild and shorter duration

Herpes 



Risks of infection 

Higher risk of contracting other STDs (breaks in the skin)



Transmission during delivery ( fetal meningitis, seizures, brain damage)

Infected people remain infected for life! There is NO CURE 

Virus stays hidden in the body between episodes and reactivates  0-5 times a year, usually lessen over time



Management 

Antiviral medication to reduce number and severity of outbreaks  Given during and occasionally in between outbreaks



Avoid sexual contact during an outbreak (although transmission also possible between outbreaks)

Chlamydia and Gonorrhea  Bacteria: Chlamydia trachomatis, Neisseria gonorrhoeae  Passed through  Vaginal, oral, anal sex

 Mother to baby (delivery)  Chalmydia only: infected body fluids contacting eye

(chlamydial conjunctivitis), or ingested (pneumonia)  NOT passed through inanimate objects (towel,

doorknob, toilet)

Chlamydia and Gonorrhea  Symptoms in boys (not always present)  Appear  2-7 days after infection (gonorrhea)  3 weeks after infection (chlamydia)

 Urethritis – discharge, irritation, or burning from

urethra  Rarely – swollen testicles or inflammation of the

epididymis  scar, infertility  Gonorrhea can affect other organs (throat, eyes, heart,

brain, skin, joints)

Chlamydia and Gonorrhea  Chlamydia and gonorrhea are most damaging in girls

(Pelvic inflammatory disease, infertility, ectopic pregnancy, fetal complications)

 Evaluation: both partners need to be tested and treated,

even if asymptomatic 

Partners from the last 2 months or last sexual partner if last active > 2 months ago

 Treatment 

Antibiotics: does not reverse damage to the female reproductive tract or other organs, so treat early



Abstain from sex until after treatment



Avoid reinfection

HPV  HPV (Human Papilloma Virus)  >100 types  Different strains may cause warts or increase risk for

penile/cervical cancer  Warts on hands and feet usually caused by different

strains than the ones that cause genital warts or cervical/penile cancer

 Transmission:  Skin to skin or skin to mucous membrane

 Mom to baby

Symptoms  Most HPV infections have no signs or

symptoms

 Genital warts: 

Appear several weeks to months after exposure



Flat or raised, single or many, small or large



Not always visible to the naked eye and generally don’t cause discomfort  But may spread even without symptoms



Appear on penis, scrotum, anus



Not all bumps are warts

HPV Prevention  Vaccine (Gardasil) 

Approved for ages 9-26



CDC-recommended for girls 11-26, boys 11-21  Supported by AAP, AAFP, ACOG



Protects against strains that cause 90% warts and 75% of cervical cancers (girls only)



Three injections over a 6 month period



Still beneficial to get vaccine even if already sexually active



Side effects: uncommon, minor (swelling/pain at injection site, fainting, allergic reaction)

 Note: condoms do not protect against warts being

transmitted from uncovered areas

HPV Treatment  No cure - the virus is always there (treatment may

reduce number of warts or speed recovery)  Warts - topical medications, laser, freezing

 Cancer - individualized

Hepatitis  Inflammation of the liver  Can be infectious or not (ie alcohol or toxin-related)

 5 Hepatitis-causing viruses  A, E – Transmitted through food (fecal/oral)  B, C, D –Transmitted sexually, through blood/body

fluids/needles, or maternally  Hepatitis B and C may have limited or chronic courses

Hepatitis  Symptoms (acute infection) 

Usually delayed (6 weeks to 6 months)



Flu-like (nausea, poor appetite, mild fever)



Belly pain in upper-right abdomen (liver)



Jaundice – yellow skin and eyes, brown urine

 Risks of chronic infection 

Liver damage/failure



Death

Hepatitis - Prevention  Hepatitis B vaccine (routine in newborns)  Vaccine not available for Hepatitis C

 Abstain from sex or use protection

 Avoid contact with infected blood, shared needles,

toothbrushes, razors  Hygienic practices at tattoo and piercing places

Hepatitis - Treatment  Post-exposure vaccine  May resolve on its own after acute infection (90% and

70% of cases of Hepatitis B and C, respectively)  Antiviral medications  The liver damage of chronic hepatitis is not reversible

HIV/AIDS 

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome



Infects and destroys the immune system, enabling serious infections and cancers that healthy people generally don’t get



Transmission: blood, semen, vaginal fluid, maternally (placenta, delivery, breast milk)



Symptoms





May not appear for years or a decade after infection (still contagious)



Symptoms relating to particular infections or cancers



Systemic symptoms (fatigue, weight loss, fevers, sweats, rash, diarrhea)

Treatment: no cure (antivirals may slow progression)

Pubic Lice (Crabs)  Tiny insects in pubic hair, suck blood from hosts

 Transmission 

Pubic hair contact during sexual encounters



Infested clothing, towels linens (can live 1-2 days off of body)

 Symptoms: itching, visible nits/insects, small bite marks  Not always preventable with

condoms (doesn’t cover pubic hair)

 Treatment: 

Prescription medication



Meticulous treatment of beddings/linens/towels

Syphillis 

Bacteria: Treponema pallidum



Transmission: direct contact with a sore (vaginal, oral anal sex), maternally



Symptoms:





1st stage (10 days to 3 months post-exposure): red, firm, painless sores on vagina, rectum, penis or mouth (chancres)



2nd stage (2-10 weeks later): rash (hands and feet), flu-like symptoms (fever, achiness)



3rd stage: systemic disease (brain, eyes, heart, spinal cord, bone), death

Treatment: antibiotics (does not undo damage already caused to body)

Questions?

Thank You!